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Matthew Woodley
01-28-2009, 07:11 PM
I apparently have a supraspinatus tendon strain. I have seen my GP and this has been diagnosed. I have got PT booked in, but the earliest I could get in is in a weeks time. Are there any exercises or rehabilitation practices I should be carrying out right now?

I only get pain when doing dips and on exercises such as shoulder press and other above head pressing lifts. Do you think it would be okay to continue lower body training like squats, lunges etc..?

Steven Low
01-28-2009, 08:04 PM
Avoid stuff that has pain. Ask your doc or PT what you are allowed to do. Probably going to be some RC rehab work to bring up strength...

Lower body work is definitely a good idea.

Garrett Smith
01-29-2009, 04:57 AM
As long as holding the bar in lower body exercises doesn't irritate your shoulder, do it.

Front squats shouldn't be a problem, but back squat type bar placement could be.

Main rule is, if it hurts, don't do it. Otherwise you should be okay until you get to the PT. Contrast hydrotherapy (hot & cold alternating, always ending on cold, google) would be helpful.

Matthew Woodley
02-20-2009, 10:11 PM
It turns out that my shoulder problem is impingement. It no longer hurts anymore and I have slowly started building up strength in the overhead press. I have been given the option of having a cortisone shot, would it be advisable to have this? I am not currently experiencing any pain. How long does it take for impingement bursitis to go away?

Garrett Smith
02-20-2009, 10:17 PM
Cortisone shot is most likely only temporary, and will weaken your tendons and ligaments in the process (this is well-accepted, not bashing conventional med). If you don't currently hurt, I would absolutely NOT do it.

More external rotation work, along with lots of thoracic anterior-posterior mobility work.

Wall Extensions (see gymnasticbodies.com youtube). DB Cuban presses. Robb Wolf's free PMenu "Kyphosis" article.

Steven Low
02-21-2009, 10:23 AM
What Garrett said.

Also, avoid pain in the exercises.... ice after any exercise. Anti-inflams are good.

Matthew Woodley
02-21-2009, 01:48 PM
Thanks guys for the quick responses. Excuse my ignorance but what exactly is anterior-posterior mobility work?

Also, how long does it usually take to recover from impingement?

Garrett Smith
02-21-2009, 02:18 PM
Getting your external rotators strong and mobilizing the thoracic spine can take weeks to months of steady work. How much time depends on your issue and how much effort and care you choose to put into it. That will likely be the long-term "cure" to your impingement, so whatever it takes, it will most likely be worth it. If you give up early or don't do it at all, modern medicine will be more than happy to provide you with cortisone injections and surgery, or alternative practitioners will offer you all sorts of treatments, when the real problem is the "posture" of your thoracic spine & scapula.

Kyphosis article. (http://cathletics.com/articles/index.php?show=shorty&shortyID=33&searchTerms=kyphosis)

Wall extensions. (http://gymnasticbodies.com/forum/viewtopic.php?f=17&t=1191)

DB Cuban press. (http://bodybuilding.com/fun/exercises.php?Name=Cuban+Press)

Article on thoracic spine health and mobility. (http://www.sportsinjurybulletin.com/archive/thoracic-spine.htm) Anterior and posterior mobilty of the thoracic spine means the ability (or not) to translate the thoracic spine "forwards" and "backwards" (think chest forward and chest sunken).

That should cover it.

Steven Low
02-21-2009, 07:27 PM
Garrett's got it.

Recovery depends on how bad it is.... like any injury.

Garrett Smith
02-21-2009, 09:30 PM
I forgot to add, I've got a mild issue with impingement in my right shoulder.

I have good thoracic mobility and good scapular stability from the gymnastics training.

Adding the external rotation work is the last key, I need more strength in that area.

I believe that will pretty much take care of the issue, and I plan on maintaining that strength.

If the cause of the impingement isn't fixed, it will keep coming back, especially as one does more and heavier "overhead" work.

Marcial Lafuente
02-22-2009, 04:26 AM
I apparently have a supraspinatus tendon strain. I have seen my GP and this has been diagnosed. I have got PT booked in, but the earliest I could get in is in a weeks time. Are there any exercises or rehabilitation practices I should be carrying out right now?

I only get pain when doing dips and on exercises such as shoulder press and other above head pressing lifts. Do you think it would be okay to continue lower body training like squats, lunges etc..?

I have the same problem.
After reading several articles from Poliquin, I started doing exercises for strenghtening my rotator cuff. Poor man shoulder rotations and similar, increasing weights.
It didnīt work. In the end it was even worse.
Then I read some articles by Eric Cressey about this issue and I followed his advice which is similar to what Garrett Smith has pointed in his post

- Avoid bench pressing. I do different kind of push ups
- Thoracic mobility
- Shoulder dislocations
- Wall slides (I canīt still do a proper one but I have improved quite a lot)
- Some foam roller and tennis ball massage
- A lot of pec stretching
Lying in a bench, with real light dumbells
1/ Arms in a cross and hold the position
2/ Arms in 90š degrees (arm and forearm parallel to the ground) and hold the position

After a month and a half my condition has improved a lot. No pain at all, much better range of movement.
I have no problems with any kind of overhead press
No bench pressing and no dips for the moment

Garrett Smith
02-22-2009, 07:17 AM
Nice job, Marcial!

Steven Low
02-22-2009, 10:37 AM
Cressey and Robertson always have pretty good advice for building back mobility.

Congrats Marcial... but keep up the work otherwise you can easily relapse. :)

Ben Fury
02-22-2009, 10:52 AM
If you really want to send that supraspinatus some love. Get both of Aaron Mattes' books:
Active Isolated Stretching
Active Isolated Strengthening

Then drop me an email and I'll walk you through building a routine from the exercises in there.

I did a two hour session on a Thursday with a lady scheduled for shoulder surgery on Tuesday and she was able to cancel the surgery. We restored 70 degrees of coronal and 60 degrees of horizontal (axial) shoulder abduction in that one session.

After we stretch, we strengthen! But in the meantime, the big weights are going to have to take a break for a few weeks to let that shoulder heal. Make haste slowly. It's little baby weights shoulder love time.

Matthew Woodley
02-22-2009, 03:55 PM
Thanks everyone for all the great advice. I just got my results back from an ultrasound....

INDICATION:
Positive impingement test of right ? rotator cuff.

FINDINGS:

The suprasprinatus, infrasprinatus and subscapularis tendons are normal in appearance, with no tear, calcific tendinosis or tendinopathy detected in these tendons.

The subdeltoid bursa is thickened and shows bunching with abduction, no subdeltoid bursal effusion or joint effusion detected.


OPINION:
Sub acrominal bursitis, otherwise a normal rotator cuff ultrasound. No tear detected. We can administer an ultrasound guided steroid and local anaesthetic injection to relieve symptoms if clinically appropriate.


Since I have no pain, I have decided I will definitely not get the cortisone injection. Yeh so I guess just continue the rehab...:)

Garrett Smith
02-22-2009, 09:06 PM
Good choice.

Ben Fury
02-25-2009, 01:45 AM
The subdeltoid bursa is thickened and shows bunching with abduction, no subdeltoid bursal effusion or joint effusion detected.

Very good news! Most definitely will want to avoid anything that squishes that bursa between your greater tubercle and acromion!! No dips or benching for you anytime soon.

Take it slow and here's to your complete and full recovery!